In today’s episode, Dr Nirala Jacobi is in conversation with Dr Carrie Jones. Dr Jones is a Naturopathic Doctor and hormone specialist from Portland. She has completed a two-year residency in advanced women’s health, gynaecology and hormones, and has also completed her Masters of Public Health at the Grand Canyon University. Dr Jones has been the medical director of two large integrative medical clinics in Portland and is currently the medical director of Precision Analytical, a laboratory that offers the DUTCH Profile. She writes for multiple health websites and is featured in a range of health podcasts. Topics discussed include Hormones and their relationship to functional digestive disorders. Digestive flares before a woman’s period and why this can occur. How gut inflammation can affect hormones - for example by raising cortisol, raising estrogen, raising 5 alpha reductase, lowering dehydroepiandrosterone sulfate (DHEA-S), affecting the absorption of nutrients that comprise hormones. How lipopolysaccharides (LPS) and endotoxemia can impair and congest phase 1 and 2 liver detoxification pathways. Nutritional cofactors required to support smooth Catechol-O-methyltransferase (COMT) functioning, especially in light of COMT single-nucleotide polymorphisms (SNPs). Symptoms of estrogen dominance in men and women. Hormone patterns related to a dysfunctional gut microbiome. The estrobolome and how it can dictate how much beta-glucuronidase is produced, as well as how much dehydroepiandrosterone (DHEA) is released from the body. All about estrogen metabolism, the different metabolites that are produced, which ones are beneficial, and the liver pathways used for processing. Which estrogen metabolising pathways have associated cancer risk? The role of beta-glucuronidase in disrupting estrogen excretion. High toxic load patients and how hormone disruptors affect CYP enzymes and estrogen receptors. How can a patient show symptoms of estrogen dominance and yet their hormonal profiles be ok? Hint: If proliferative estrogen metabolising pathways favoured. When to intervene for hormonal balance when client presents with gastrointestinal issues? In light of high levels of beta-glucuronidase. How to test for beta-glucuronidase - fecal. What can we do about estrogen dominance? Support for Phase 1 Diindolylmethane (DIM) for clients favouring unhealthy 4-OH E1 or 16a-OH E1 pathways. Dietary adjustment to include Indole-3-carbinol (I3C) containing vegetables. Broccoli sprout powder for sulforaphane (to activate quinone reductase) Helps reverse the effects of going down unhealthy 4-OH E1 pathway. Glutathione support with N-acetylcysteine (NAC), and liposomal glutathione. Support for Phase 2 (COMT support) Magnesium Methylated B Vitamins Methionine Choline S-Adenosyl-L-Methionine (SAMe) Gut treatment Calcium D-glucarate to help lower beta-glucuronidase levels. Fibrous foods to bind free floating estrogen. Note: Broccoli and fibrous products not recommended in phase 1 of SIBO treatment. When to use binders in detoxification treatment. Progesterone Why can people with bloating potentially be progesterone deficient? Progesterone cream in second half of the cycle versus vitex supplementation - what age groups are appropriate to each? DUTCH testing - what is the difference between all the testing available? Saliva tests - free hormones. Blood tests - hormones are bound to sex hormone binding globulins or other carrier proteins. DUTCH test - free hormones and metabolites. Cortisol and cortisone - how to assess beyond an adrenal stress index, the difference between both forms, and why the body may have a pattern of inactivating cortisol into cortisone. How to balance cortisol to cortisone ratio? The role of licorice (Glycyrrhiza glabra) Flatlining cortisol and its role as a marker for chronic infection, its association with an increased risk for cancer, and increased risk for autoimmune issues. The cortisol awakening response and how it works with the thymus gland to destroy autoimmune antibodies. The link between chronic infections and low cortisol, and how to address. All about DHEA and DHEA-S Counters stress Energy, bone health, neurotransmitter balance, sex drive, muscle development. 7-keto DHEA - what is this? Supporting DHEA via adrenal support. When and when not to test hormone levels. Endometriosis and digestive disturbance due to adhesions, inflammation, and excess estrogen. New developments in the hormonal testing field. IBS symptoms around the period and why this may be. The importance of structural alignment for uterine and intestinal health. Therapy to address structural alignment - visceral manipulation, pelvic massages, and bodywork. Flaxseeds Helpful for estrogen dominance Raises SHBG (note that flaxseeds preferentially bind testosterone - so care in women who are struggling with testosterone levels) Soy The role of fermented soy for hormonal balance in menopause. Is soy estrogenic, or does it downregulate the proliferative estrogen pathway? Dr Carrie Jones’ 2018 hormone education plans for practitioners and patients. Resources Dr Carrie Jones Precision Analytical for Dutch Testing A5M conference 2017 Dr Chris Shade Podcast - detoxification Dr Walter Crinnion - environmental medicine

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